Stockton-on-Tees Borough Council

Big plans, bright future

Adult Services and Health Select Committee Minutes

Date:
Tuesday, 4th March, 2014
Time:
4.00 p.m.
Place:
Ground Floor Committee Room, Town Hall, Stockton on Tees
 
Please note: all Minutes are subject to approval at the next Meeting

Attendance Details

Present:
Cllr Kevin Faulks(In The Chair), Cllr Paul Baker, Cllr Evaline Cunningham, Cllr Elliot Kennedy, Cllr Ray McCall, Walmsley, Cllr Norma Wilburn, Cllr Mrs Mary Womphrey.
Officers:
Barbara Carr, Keith Wheldon, Peter Tindall, Jean McLeod, Sue Piggott(North Tees and Hartlepool Foundation Trust), Martin Booth, Toni McHale(Health Watch), Deborah Bowden(North East Commissioning Support), Peter Mennear and Kirsty Wannop(LDS).
In Attendance:
Cllr Ken Lupton
Apologies for absence:
Cllr Javed, Cllr Mrs Sylvia Walmsley and Deborah Miller
Item Description Decision
Public
ASH
87/13
DECLARATIONS OF INTEREST
 
ASH
88/13
RECONFIGURATION OF EMERGENCY MEDICINE AND CRITICAL CARE AT NORTH TEES AND HARTLEPOOL NHS FOUNDATION TRUST
AGREED that the information be noted.
ASH
89/13
NORTH TEES AND HARTLEPOOL NHS FOUNDATION TRUST QUALITY ACCOUNT 2014-15
AGREED that the
i) information be noted
ii) a draft statement of assurance be circulated following the meeting with final approval delegated to chair and vice-chair.
ASH
90/13
UPDATE FROM HEALTHWATCH STOCKTON-ON-TEES
AGREED that the information be noted.
ASH
91/13
WORK PROGRAMME
AGREED the work programme be noted.
ASH
92/13
CHAIR'S UPDATE
 
4.00pm/6.00pm

Preamble

ItemPreamble
ASH
87/13
Cllr Ray McCall declared a personal interest as he was an Associate Hospital Manager and Governor for Tees, Esk and Wear Valleys NHS Foundation Trust.

Cllr Ken Lupton declared a non-prejudicial interest as director of the trust.
ASH
88/13
Members considered an update on the implementation of the reconfiguration of emergency medicine and critical care services from the North Tees and Hartlepool NHS Foundation Trust Hartlepool site to the Stockton site at North Tees Hospital.

The Committee received a presentation that included the following:-
- The approach to the evaluation that included a Project Sub Group to monitor the impact of the reconfiguration, use of existing Trust indicators to provide an overview of the impact and summary dashboard to provide over and assurance to the Oversight Group. There had also been Joint Overview and Scrutiny Committee meeting before the services moved, to discuss any issues there could be.
- Information from the dashboard set up to monitor the implementation regarding A&E, Referral to treatment, Health Care Acquired infections, Eliminating mixed sex accommodation targets and statics from during the move and into the new year 2014.
- Activity within A&E including attendances, emergency admission in A&E and the Emergency Assessment. The percentage of patients receiving first assessment on the Emergency Assessment within 2 hours of admission and percentage receiving Consultant review within 14 hours of admission.

In January the occupancy of the new rehabilitation ward at Hartlepool was approaching 100% and staff were becoming more confident in the usage of the unit for appropriate patients to ensure they were treated closer to home following their acute episode at North Tees. Members queried the transfer protocols and it was outlined that patients would be transferred where appropriate, generally those patients who would need 3-10 days of support before going home.

- Information regarding patient and staff outcomes including the Friends and Family test. It was highlighted that this wasn't as high as wanted but is expected as patients or their friends and families could not be forced to complete them. Trusts did not have to use a standard approach when carrying out the Test.

The Trust's final evaluation report would be distributed in due course.
ASH
89/13
The Committee considered the outline performance against the Trust's quality priorities for 2013-14. The Quality Account consisted of three domains: patient safety, effectiveness of care and patient experience. It looked back over 2013-14 and forward to 2014-15. It identified the priorities for 2014-15 and how they would be delivered.

The information provided included the following:
- Details around each Quality priority from 2013/14, the aim of the priority and what they had achieved and what they still needed to do in 2014/15.
- Performance figures against quality metric and the projected outturn figures for 2013/14 compared to previous years.

Members raised the following point/comments/questions:
- The National NHS Staff Survey showed some areas of concern including the percentage of staff who would rate the Trust as a place to work or receive treatment was lower than average and work was needed to be done to understand and improve this. Trust representatives recognised that this was a key issue, particularly as most Trust staff lived locally and they and their families would often be treated by the Trust.

- Members discussed the end of life pathway and family's voice diary. Guidance had been introduced to improve staff usage of the family diaries

The national debate around the end of life Liverpool Care Pathway had led to some clinical reluctance to use the Trust's end of life pathway, and as the diaries were offered at the same time as the pathway, this had led to a decrease in number of diaries completed during 2013-14. However of those that had been completed, the average daily score had been reassuringly high. Regional discussions were continuing on the implementation of end of life care pathways.

- The Trust had been asked in advance to provide additional information on complaints, their response to recent national reviews including the Francis Report, and mortality rates.

- Members queried that the Summary Hospital-level Mortality Indicator (SHMI) figure was above the national expected figure (112.39 compared to 100). SHMI measures deaths up to 30 days following discharge. The Committee was provided with the top seven diagnosis groups that had the highest difference between expected and actual figures, and the highest group was pneumonia, followed by urinary tract infections.

Trust representatives outlined that the issues was being looked at in various ways including a breakdown of cases by ward, examining disease profiles, and undertaking reviews of individual cases. The health profile of the local population was also a factor.

A project on pneumonia with the North East Quality Observatory System was also due to take place from April. NEQOS would also be reviewing the Trust's case notes review process.


- Members praised the culture of reporting staff medication errors.
ASH
90/13
The Committee considered an update from Healthwatch on their work in Stockton-On-Tees.

The main information included:
- The role of Healthwatch and its purpose to represent the voice of the consumer/patient/service user of health and social care services and influence how the services were planned and delivered.
- The Healthwatch Board, Membership and staff. Healthwatch was using a ‘network of networks' approach to be accessible to the population using existing methods where possible.
- Details of Healthwatch's work programme detailing the areas it would concentrate on that included; discharge from North Tees University Hospital, personalisation of care budgets, and breastfeeding. Another of its key priorities was raising the public profile.

Members raised the following points/comments/questions:
- Co-ordination with the Committee, and the Health and Wellbeing Board.
- Healthwatch should look at having drop in opportunities within easy accessible place. A hot desking approach was being developed.
- Included information in Stockton News and also provide information to Cllrs to include in their newsletters.
- Members queried how the interests of associated networks would be balanced against others. The Board would be in overall control, and the organisation was also encouraging individual membership.
ASH
92/13
The Committee was informed of two upcoming events. A training session on reviewing Home Care, and a CCG-led event to feed back on their Call to Action consultation.

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